NPI 1457681736

Project Patch

Organisation Emotionally Disturbed Childrens' Residential Treatment Facility Garden Valley, ID

Practice location

Address: 25 Miracle Ln # 450, Garden Valley, ID 83622-1044
Phone: (208) 462-3074
Fax: (208) 462-3209
Mailing address: PO Box 820209, Vancouver, WA 98682-0004

Authorised official

Name: Chuck a Hagele
Title: Chief Operating Officer
Phone: (360) 690-8495

Registered specialties

Emotionally Disturbed Childrens' Residential Treatment Facility Primary

Residential Treatment Facilities Taxonomy 322D00000X Licence 26124 (ID)

Other Residential Treatment Facility, Emotionally Disturbed Children providers in Idaho →

Registry record

NPI: 1457681736
Entity type: Organization
NPI issued: 8 Jan 2010
Record last updated: 28 Apr 2026

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.